Cognitive behavioral therapy can have several areas of focus. It should identify risk factors such as previous suicide attempts, family history of suicide, and address current suicidal ideation. The emphasis is on the present issues that currently affect patient function. Within establishing a positive doctor-patient relationship, it also concentrates on the development of better coping skills, focused homework assignments, stressing medicinal or other adherence, and combating potential chemical dependence. Further benefit may come from involving families regarding safety issues, such as removing access to firearms.
Six month followup studies in subjects with suicidal ideation revealed less deaths due to suicide reattempts in those treated with cognitive behavioral therapy. Patients who received cognitive behavioral therapy expressed improvements in mood, outlook, problem solving capacity, and diminished suicidal thinking.
A comprehensive approach is required while evaluating patients since every individual who attempts suicide has different circumstances. Apart from a previous history of suicide attempt, such ideation can also reoccur due to persistent illness, hopelessness, intoxication, impulsivity, resistance, and side effects induced by pharmacotherapies or insufficient medicinal efficacy. In summary, there is a need for psychotherapy to target specific risk factors and reduce suicide reattempts. Our patients should be encouraged to participate in cognitive behavioral therapy during followup and obtain the advantages of continuing it with medical treatments.
by Dr. Hema Madhuri Mekala MD
Psychiatry Resident, Griffin Memorial Hospital (Norman, OK)